Effects of DRG pulsed radiofrequency parameters on the clinical outcome for battered sensory never syndrome: a prospective, triple-blind, randomized controlled trial

Battered Sensory Never Syndrome (BSNS) is a condition characterized by persistent, long-term mechanical compression of the sensory roots, dorsal root ganglia (DRG), and sensory fibers of the spinal nerve roots. This leads to symptoms such as hyperalgesia or allodynia, paresthesia, and radicular pain-like syndromes where pain worsens with weight-bearing or physical activity. High-voltage DRG pulsed radiofrequency (PRF) is effective for BSNS, but optimal treatment parameters for the best clinical efficacy remain undefined. This study aims to compare the clinical outcomes of various PRF temperatures and durations in patients with BSNS. Patients with BSNS were randomized to one of four high-voltage (80 V) PRF parameter groups: 42℃/3min, 42℃/12min, 55℃/3min, and 55℃/12min. The primary outcome measures included the Numerical Rating Scale (NRS) and the Oswestry Disability Index (ODI). The secondary outcome measures included the Hamilton Anxiety Scale (HAMA), the Hamilton Depression Scale (HAMD), the Pittsburgh Sleep Quality Index (PSQI) scores, the effective rate of pain relief, the proportion of patients with a ≥ 50% reduction in ODI score, and medication usage. These were evaluated before PRF and within 12 months after surgery. All patients included in our study had a mean age over 60, with the majority being female. Four patient groups showed significant reductions in NRS, ODI, HAMA, HAMD scores (P < 0.05) and decreased medication use within 12 months post-PRF, with no statistically significant differences between the groups (P > 0.05). The PSQI scores decreased significantly only in the 42 °C/3min group at 1 month,3 and 6 months (P < 0.05), also without intergroup significance (P > 0.05). The subgroup analysis by time and temperature revealed that NRS scores (P = 0.009), the number of patients with effective pain relief (P = 0.039) and ODI reduction ≥ 50% (P = 0.045) 1 month after PRF in the 55℃ group were significantly better than those in the 42℃ group, while no statistically significant difference was found between 3-min and 12-min durations (P > 0.05). High-voltage DRG PRF effectively treats BSNS patients within a treatment duration range of 3 to 12 min. Treatment at 55 °C offers superior pain relief and physical function improvement without neuropathic complications.